| NPI | 1881720381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-013676) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501013141) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2014-12-11 |